[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1753 Introduced in Senate (IS)]
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119th CONGRESS
1st Session
S. 1753
To require the Secretary of Health and Human Services to establish
reference prices for prescription drugs for purposes of Federal health
programs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 14, 2025
Mr. Merkley (for himself, Mr. Welch, Mr. Sanders, and Mr. Durbin)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To require the Secretary of Health and Human Services to establish
reference prices for prescription drugs for purposes of Federal health
programs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``End Price Gouging for Medications
Act''.
SEC. 2. REFERENCE PRICES FOR PRESCRIPTION DRUGS.
(a) Reference Prices.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary''), in accordance with
subsection (b), shall establish annual reference prices for each
prescription drug. Notwithstanding any other provision of law, with
respect to enrollees or beneficiaries in any of the Federal health
programs described in subsection (c), the retail list price for a drug
shall not exceed the reference price for such drug.
(b) Criteria.--
(1) In general.--Each year, the Secretary shall establish
the reference price for each prescription drug under subsection
(a)--
(A) by determining the lowest retail list price for
the drug among the reference countries in which the
drug is available, if drug pricing information is
available for at least 3 of such countries; or
(B) in the case of a drug for which drug pricing
information or dosage equivalents are not available for
at least 3 of the reference countries, by determining
an appropriate price based on the Secretary's
determination of--
(i) the added therapeutic effect of the
drug;
(ii) the value of the drug;
(iii) patient access to the drug;
(iv) the costs associated with researching
and developing the drug; and
(v) other factors, as the Secretary
determines appropriate.
(2) Reference countries.--For purposes of paragraph (1),
the reference countries are Australia, Austria, Belgium,
Canada, France, Germany, Italy, Japan, the Netherlands, Sweden,
Switzerland, and the United Kingdom.
(c) Federal Health Programs.--The reference prices established
under subsection (a) shall apply with respect to covered inpatient and
outpatient drugs under--
(1) the Medicare program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.);
(2) a State Medicaid plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.);
(3) the State Children's Health Insurance Program under
title XXI of the Social Security Act (42 U.S.C. 1397aa et
seq.);
(4) the TRICARE program under chapter 55 of title 10,
United States Code;
(5) hospital care and medical services furnished by the
Department of Veterans Affairs under chapters 17 and 18 of
title 38, United States Code;
(6) the Federal Employees Health Benefits Program
established under chapter 89 of title 5, United States Code;
and
(7) any health program, service, function, activity, or
facility funded, in whole or part, under the Indian Health Care
Improvement Act (25 U.S.C. 1601 et seq.), including through
direct or contract care provided under such Act or through a
contract or compact under the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 5304 et seq.).
(d) Applicability to Other Purchasers of Drugs.--Notwithstanding
any other provision of law, a drug manufacturer shall offer
prescription drugs at the reference price to all individuals, including
individuals who are not insured and individuals who are covered under a
group health plan or group or individual health insurance coverage. In
the case of individuals covered by a group health plan or group or
individual health insurance coverage, such requirement is met if the
amount covered under such plan or coverage plus the cost-sharing amount
does not exceed the reference price.
(e) Enforcement.--
(1) Civil penalty.--A drug manufacturer who does not comply
with the requirements of subsection (a) shall be subject to a
civil penalty, for each year in which the violation occurs and
with respect to each drug for which the violation occurs, in an
amount equal to 5 times the difference between--
(A) the total amount received by the manufacturer
for sales of the drug under the Federal health programs
under subsection (c) for the year; less
(B) the total amount the manufacturer would have
received for sales of the drug under such programs for
the year if the manufacturer had complied with
subsection (a).
(2) Amounts collected.--Each year, the Secretary of the
Treasury shall transfer to the Director of the National
Institutes of Health an amount equal to the amount collected in
civil penalties under subsection (e) for the previous year. The
Director of the National Institutes of Health shall use amounts
so transferred for purposes of conducting drug research and
development.
(f) Applicability to Brand and Generic Drugs.--The reference price
established under subsection (a) shall apply to drugs approved under
subsection (c) or (j) of section 505 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355) or under subsection (a) or (k) of section
351 of the Public Health Service Act (42 U.S.C. 262).
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